Suzuki et al. (21) | Prospective, open-label, randomized | 109, any severity of COPD | Erythromycin 200–400 mg daily v. riboflavin for 12 mo | Significant reduction in common colds (1.24 ± 0.07 v. 4.54 ± 0.02 for erythromycin and riboflavin groups; p < 0.001) and exacerbations (RR for control group 4.71, 95% CI 1.53–14.5) |
Banerjee et al. (25) | Prospective, double-blind, randomized | 67, moderate to severe COPD | Clarithromycin 500 mg daily v. placebo for 3 mo | Significant improvement in symptom domain of SGRQ (mean difference 10.2, 95% CI 1.6–18.7); no significant difference in SGRQ score* or exacerbation frequency (5 v. 3 in clarithromycin and placebo groups; p = 0.2). |
Seemungal et al. (20) | Prospective, double-blind, randomized | 109, moderate to severe COPD | Erythromycin 250 mg daily v. placebo for 12 mo | Significant reduction in exacerbation frequency (rate ratio 0.648 [95% CI 0.489–0.859] for erythromycin v. control group); no difference in sputum markers of inflammation (IL-6, IL-8, myeloperoxidase) |
Albert et al. (26) | Prospective, double-blind, randomized | 1142, moderate to very severe COPD (GOLD stages II–IV) | Azithromycin 250 mg daily v. placebo for 12 mo | Significant reduction in exacerbation frequency (HR 0.73, 95% CI 0.63–0.84); increase in median time to next exacerbation (266 v. 174 d for azithromycin and placebo groups; p < 0.001); significant improvement in SGRQ (2.8 ± 12.8 v. 0.6 ± 11.4 units, p = 0.004); reduction in unscheduled office visits (HR 0.85, 95% CI 0.74–0.98); no significant difference in rates of hospital admission (HR 0.94, 95% CI 0.76–1.15) |